Materiais de preenchimento endodôntico para terapia pulpar em dentes decíduos
: uma umbrella review

  • Inês Filipa Pereira Neves dos Santos (Student)

Student thesis: Master's Thesis

Abstract

Introduction: Caries disease in childhood is still a serious health problem, and the presence of caries lesions in deciduous teeth may generate the need for some type of pulp treatment. Knowing how to choose the best type of treatment is always a clinical challenge. Furthermore, there are different possibilities of endodontic filling materials, and it is important to know how to select the most appropriate one for each type of treatment. Objetive: The objective of the present study was to perform a systematic review, of the umbrella review type, on different types of pulp treatment and endodontic filling materials in deciduous teeth. Materials and Methods: The PICO (S) question ("What is the best type of pulp treatment and endodontic filling material for deciduous teeth?") was established. The search strategy was defined and used in the selected databases (PubMed, Web of Science and Scopus). The methodological quality of this umbrella review was assessed using the AMSTAR-2 tool, while the risk of bias with ROBIS. On the other hand, the level of evidence analysis was evaluated using the GRADE tool. Results: A total of 8 systematic reviews were included. Three of the included studies evaluated pulp treatment (endpoint 1) and the remaining 5 evaluated endodontic materials (endpoint 2). Regarding pulp treatment, selective removal/indirect pulp protection proved to be effective, with cavity sealing being a very important factor, especially the hall technique, with the best clinical success rates. Direct pulp protection is a procedure that depends on clinical factors that are difficult to evaluate, and it may be more effective to evolve to pulpectomy in situations of pulp exposure. When comparing the endodontic treatment (with and without instrumentation) there is no evidence of superiority between the different types. As for the materials used for pulpotomy, formocresol and MTA have high rates of clinical success, while in the endodontic filling materials, oxide-based fillers have high rates of clinical success. Zinc oxide and eugenol, and calcium hydroxide and iodoform fillings have a good level of clinical evidence. Conclusion: It can be concluded that regarding the types of pulp treatment, the conservative one, using selective removal associated with a good material or technique for sealing the cavity, has a high rate of clinical success. Direct pulp protection is not a safe and predictable option, and the endodontic treatment that uses instrumentation cannot yet be replaced by the option of not instrumenting. For the materials used in the different types of pulp treatment, pulpotomy with MTA or formocresol has a high level of scientific evidence and clinical success, while endodontic treatment can be performed with pastes based on zinc oxide and eugenol or calcium hydroxide associated with iodoform.
Date of Award23 Sept 2022
Original languagePortuguese
Awarding Institution
  • Universidade Católica Portuguesa
SupervisorAnna Moura (Supervisor), Patrícia Nunes Correia (Co-Supervisor) & Tamara Kerber Tedesco (Co-Supervisor)

Keywords

  • Dental caries
  • Pulpotomy
  • Pulpectomy
  • Tooth deciduous
  • Systematic review

Designation

  • Mestrado em Medicina Dentária

Cite this

'